<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <!--<div class="form-group">-->
    <!--    <label class="control-label col-xs-12 col-sm-2">{:__('User_id')}:</label>-->
    <!--    <div class="col-xs-12 col-sm-8">-->
    <!--        <input id="c-user_id" data-rule="required" data-source="user/user/index" data-field="nickname" class="form-control selectpage" name="row[user_id]" type="text" value="{$row.user_id|htmlentities}">-->
    <!--    </div>-->
    <!--</div>-->
    
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Coupon_category_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-coupon_category_id" disabled="disabled" data-rule="required" data-source="coupons/category/index" data-field="nametext" class="form-control selectpage" name="row[coupon_category_id]" type="text" value="{$row.coupon_category_id|htmlentities}">
        </div>
    </div>
    
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Begintime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-begintime" data-rule=""  disabled="disabled"  class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[begintime]" type="text" value="{:$row.begintime?datetime($row.begintime):''}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Endtime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-endtime" data-rule="" disabled="disabled"  class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[endtime]" type="text" value="{:$row.endtime?datetime($row.endtime):''}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Clinic_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-clinic_id" data-rule="" data-source="coupons/clinic/index" class="form-control selectpage" name="row[clinic_id]" type="text" value="{$row.clinic_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
     <label class="control-label col-xs-12 col-sm-2">{:__('Appointmenttime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-appointmenttime" data-rule="" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:00:00" data-use-current="true" name="row[appointmenttime]" type="text" value="{:$row.appointmenttime?datetime($row.appointmenttime):''}">
        </div>
    </div>
    <div class="form-group">
    <label class="control-label col-xs-12 col-sm-2">{:__('Finishtime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-finishtime" data-rule="" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:00:00" data-use-current="true" name="row[finishtime]" type="text" value="{:$row.finishtime?datetime($row.finishtime):''}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Statusdata')}:</label>
        <div class="col-xs-12 col-sm-8">
            
            <div class="radio">
            {foreach name="statusdataList" item="vo"}
            <label for="row[statusdata]-{$key}"><input id="row[statusdata]-{$key}" name="row[statusdata]" type="radio" value="{$key}" {in name="key" value="$row.statusdata"}checked{/in} /> {$vo}</label> 
            {/foreach}
            </div>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Number')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-number" data-rule="" readonly="" class="form-control" name="row[number]" type="text" value="{$row.number|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Qrcodeimage')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-qrcodeimage" disabled="disabled" data-rule="required" class="form-control" size="50" name="row[qrcodeimage]" type="text" value="{$row.qrcodeimage|htmlentities}">
                <!--<div class="input-group-addon no-border no-padding" style="display:none">-->
                <!--    <span><button type="button" id="faupload-qrcodeimage" class="btn btn-danger faupload" data-input-id="c-qrcodeimage" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp" data-multiple="false" data-preview-id="p-qrcodeimage"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>-->
                <!--    <span><button type="button" id="fachoose-qrcodeimage" class="btn btn-primary fachoose" data-input-id="c-qrcodeimage" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>-->
                <!--</div>-->
                <span class="msg-box n-right" for="c-qrcodeimage"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-qrcodeimage"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Platform')}:</label>
        <div class="col-xs-12 col-sm-8">
                        
            <select  id="c-platform" data-rule="required" readonly="readonly" class="form-control selectpicker" name="row[platform]">
                {foreach name="platformList" item="vo"}
                    <option value="{$key}" {in name="key" value="$row.platform"}selected{/in}>{$vo}</option>
                {/foreach}
            </select>

        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-name" data-rule="" readonly="" class="form-control" name="row[name]" type="text" value="{$row.name|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Staffnumber')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-staffnumber" data-rule="" readonly="" class="form-control" name="row[staffnumber]" type="text" value="{$row.staffnumber|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">客人姓名:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-username" data-rule="" class="form-control" name="row[username]" type="text" value="{$row.username|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">客人电话:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-phonenumber" data-rule="" class="form-control" name="row[phonenumber]" type="text" value="{$row.phonenumber|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Unionid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-unionid" data-rule="" readonly="" class="form-control" name="row[unionid]" type="text" value="{$row.unionid|htmlentities}">
        </div>
    </div>
    <div class="form-group"  id="c-sn-c">
        <label class="control-label col-xs-12 col-sm-2">财务订单号:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-sn" data-rule="" class="form-control" name="row[finance_sn]" type="text" value="{$row.finance_sn|htmlentities}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>